2020 FMJ S.T.E.M. Camp- Health Form
Participants Name *
I understand that pictures and/or videos of my child maybe taken during STEM camp while participating within STEM camp activities. These pictures may or may not be posted to any of the FMJ's or Roane County Schools websites and/or any of FMJ's or Roane County School's social media accounts. In marking YES I give permission for picture and/or videos of my child to be taken and potentially posted. In marking NO i understand that you will need to talk to Camp Director Jason Young so he can make the FMJ social media team aware of your decision.
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Guardians Name *
Guardians Email *
Home Address *
Emergency Phone numbers *
Emergency Phone numbers *
Emergency Phone numbers *
Physicians Name *
Physicians Phone Number *
In case of an Emergency what Hospital would you prefer your child to go to. *
My child may leave camp with: *
My child may NOT leave camp with
Medications: (Place None if there are no medications) *
Medical conditions:(Place None if there are no medical conditions)
Food Allergies (Place None if there are no Food Allergies)
Other Allergies(Place None if there are no other food allergies)
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